Experienced Orthopaedic Specialists Onboard Our Clinic

We like to thank all our patients for the support so far and to better serve you, we now have 2 experienced orthopaedic specialists onboard.

Dr. Ambrose Yung who is a specialist orthopaedic consultant with experience in partial knee replacement, complex primary total knee replacement, revision knee replacement, minimal invasive knee and shoulder sports surgery.

Dr. Fong Shee Yan who is an experienced Spine-specialised Orthopaedic Consultant in Singapore practising Minimally Invasive Spine Surgery.

Join us in welcoming Dr. Ambrose & Dr. Fong and feel free to contact us if you’d like to understand more about our Clinic

 

5 Types of Orthopaedic Impairment

Orthopaedic impairments are impairments to the body which can cause a huge amount of disturbance and affect the quality of life you can achieve. It is a disability that may affect the ability to sit or walk. However, orthopaedic impairments may be treated with conventional treatments such as surgery and physiotherapy. Aids such as crutches, splints, braces and wheelchairs can also greatly improve the quality of life.

Osteomyelitis

Osteomyelitis is a chronic disease that affects the bone and joints and is triggered by bacteria. It will slowly “eat” away and destroy the bone and joints. Due to the presence of bacteria and infection, pus will be produced by the body’s immune system and this will cause discharges with bad odour. Osteomyelitis is often introduced by actions which we least expect. Walking barefooted outdoors may cause slight abrasions and bacteria can enter the body from those places. If osteomyelitis is not discovered and treated early, reconstructive surgery will be required.

Cerebral palsy

Cerebral palsy is actually a group of chronic medical conditions that affects the body’s motor conditions. It will lead to the inability for body movements, muscle tones and coordination. In serious cases, it will cause the patient to lose their mental capabilities. Cerebral palsy is due to damages to the brain that usually occurs while the baby is still in the wound. It can be caused by injuries or deformities.

Spinal tuberculosis

Tuberculosis is a deadly infectious disease and when it happens in the spine, it will slowly but surely destroy the backbone and nerves. During the process, it will cause huge physical impairment and can be deadly if it is not treated properly. Spinal tuberculosis can be easily recognised by the thickening of chest after experiencing a sharp bend at the backbone region.

Cleft lip

Cleft lip is an extremely common deformity. During the development of the body, different parts of the face are being formed on its own and the body will naturally fuse them together. Cleft lip occurs when the fusion between the maxillary and medial nasal process does not happen successfully, causing a cleft to form.

Angular bone deformity

Angular bone deformity or simply bending of the bones above the knee is caused by a variation in the normal growth pattern. Angular deformity will cause knock knees or bow legs that will become worse as the child grows. Eventually, he will have problems walking and this will cause an unavoidable joint damage over time.

3 Common Procedures Performed By Orthopaedic Surgeons

Orthopaedic surgeries are surgeries that involve the musculoskeletal system including our hands, shoulders, foot and knees. It is one of the most established arm of surgery and one of the most important. At one point or another in our lives, we will definitely require orthopaedic surgery to deal with issues such as sports injuries, musculoskeletal injuries or degenerative diseases. What are some common procedures performed by orthopaedic surgeons?

Total joint replacement

Due to ageing or diseases, a healthy joint can be damaged and rendered almost useless. In order to regain the full range of motion of a good quality lifestyle, total joint replacement will need to be performed on patients using man-made materials called biomaterials. These biomaterials are biocompatible and will mimic the actions of the actual joint. However, they cannot fully replicate the functions of the original one to a full extent. Wear and tear over a period of time can cause the cartilage to wear off, causing stiffness and pain due to the lack of synovium which helps to reduce friction.

Rotator cuff repair

Rotator cuff repair is performed to repair injured or torn tendons in the shoulder. There is a group of muscles in the shoulder joint forming a cuff, resulting in the name rotator cuff. Our shoulder offers superb flexibility and range of motion but this causes the shoulder joint to be extremely unstable. A slight impact can cause the shoulder “ball” to pop out of the “socket”, resulting in a dislocation. The presence of the tendons will hold the shoulder muscles to the shoulder, preventing any accidental popping out action. Due to injuries or overuse, the tendons can become weak and will not hold as well. Surgery may be performed either as a traditional open surgery or a more modern arthroscopy depending on the extent of the tear. The surgery will fix back the tendon to the shoulder and it will be held together by self-vanishing sutures.

Anterior Cruciate Ligament reconstruction

There are 4 major ligaments in our knee and one of the most important one is the anterior cruciate ligament (ACL). The ACL is responsible for the overall stability and even surface stress distribution across the knee. It limits the rotational capability of the knee as well as prevents excessive forward motion of the tibia to the femur. The ACL is frequently torn during sporting activities involving high impact and sudden jerks. For example during rugby, the long metal studs from the boots can be still stuck in the soft grass field and an attempt to make a directional change results in the twisting of the knee, instantly tearing the ACL. ACL reconstruction is performed either by open surgery or arthroscopic.  The surgeon will remove a tendon from the hamstring and use it as a replacement for the ACL.

Above are 3 of the most common orthopaedic surgeries performed by orthopaedic surgeons worldwide. No matter what surgery you are about to undergo, we wish you a speedy recovery.

Orthopaedic Conditions That Require Spine Surgery

Spine surgery is a major surgery that is often the last option for most surgeons due to the complexity and risks involved. Any slight mistakes or accidents can cause permanent paralysis of the body depending on the affected nerves in the spine. Surgeons will often recommend alternative treatments such as medication and physical therapy and when left with no other choices will they opt for spine surgery. With such high risks involved, what are some orthopaedic conditions that require spinal surgery to be carried out?

Herniated disc

A herniated disc occurs when one of the spinal disc in the vertebrae slips or ruptures, causing the soft disc materials to flow out of the disc. When the disc flows out, the movement and material can pinch on the surrounding nerves, causing pain and numbness. A discectomy will need to be carried out to remove this herniated disc that is pinching onto the nerve. A modern evolution is the microdiscectomy which uses high definition microscope to see better and is minimally invasive, reducing the risk.

Foraminotomy

Foraminotomy is performed to relieve pressure from an affected nerve in the spine. This pressure is caused either by bone fragments, scar tissues or excess ligament development in the spinal area, causing it to press against the spine and causing pain and numbness. Foraminotomy will open up the back where the nerve roots leave the spinal canal, reducing the chances of pinching.

Spinal fusion

As the name suggests, spinal fusion aims to join 2 or more vertebrae together to prevent excessive movement which may pinch onto the nerves. Loose vertebrae can press against the nerves during movement, causing pain and numbness. It will also prevent the surrounding soft tissues from stretching. Spinal fusion is based on the simple logic of “if it doesn’t move, it doesn’t hurt”. Similarly to welding in metals, spinal fusion will fuse the vertebrae together. This process however will reduce some flexibility in the spine but this is very minimal.

Artificial lumbar disc replacement

Artificial disc replacement is a new surgical process that uses man-made biomaterials to replace the affected intervertebral disc. The purpose of the spinal disc is to cushion the shock and distribute it evenly. Since the spinal discs do not regenerate as easily as our skin, biomaterials will need to be used to restore flexibility and motion.

Above are 4 orthopaedic conditions that warrant the usage of spinal surgery. Although the risks are there, medical advances have significantly reduced the risks and recovery time. Nonetheless, the risks are still present and serious considerations must be made before deciding on such major surgery as this.

4 Habits to Help Reduce Risk of Orthopaedic Conditions

In sunny Singapore, we tend to engage in sporting activities throughout the year. As the amount of sports activities increases, the risk of orthopaedic injuries will increase likewise. Studies have concluded that 80% of orthopaedic conditions involved the upper extremities such as the arm, shoulders and elbows whereas 20% of them involved the lower extremities such as the knee and ankle. Injuries will prevent us from continuing to be involved in our favourite activity for a period of time and this can be frustrating. What are some good habits to help you reduce the risk of orthopaedic injuries? What are some precautions you should take?

Warming up

Our body is not in the most ideal state for action most of the time. If you do a sudden sprint, you can expect to pull your hamstring and cause pain and discomfort. Therefore, proper warming up is crucial to reduce the risk of injuries. You need to prepare your body for an intense activity but doing an action that is less intensive for a few minutes to allow your body to adapt. Warming up provides heat to the body which will help to loosen up the tissues in your body such as the ligaments and tendons.

Wearing protective gears

Contact sports often require the usage of protective gears to protect you. For example, soccer requires the compulsory usage of shin guards. Although shin guards can hinder running movements and cause discomfort to players, they are useful in preventing injuries to the shin. Also, rugby players wear uniform with padding at the shoulder region to prevent injuries when they are tackled down. While players are better off without these protective gears, they know that they cannot do without them.

Knowing when to stop

Knowing when to stop is the difficult thing for most athletes out there. There is only a thin line between stupidity and bravery. Some players think that they can finish the game despite being injured via the usage of pain relieving sprays. However, the exact extent of injury is unknown and it could be a serious one which will cause more serious complications if further aggravated.

Cooling down

Cooling down sessions help to decrease the heart rate in a controlled manner and relax the muscles. Exercising causes the body’s temperature to be increased and a proper cool down session will revert back to the normal body temperature down and prevent the building up of lactic acid which will cause muscle soreness.

Knowing when to stop is probably the most difficult yet important decision you should make. Observe the 4 habits mentioned above and you will definitely have your risk of injuries significantly decreased.

4 Common Orthopaedic Injuries in Elderly people

According to studies, orthopaedic injuries are the leading cause of injuries in elderly people. Common injuries include fractures to the hip, pelvic, spine, shoulder and forearm, head injuries and soft tissue injuries. In the elderly especially, there has been an observed pattern to orthopaedic injuries. Firstly, it is the fear of injuries followed by the actual injury and subsequent medical attention and the eventual loss of mobility and the need for specialised care. Let’s discuss about some of the common orthopaedic injuries in the elderly so that we can all try to prevent it from happening to our loved ones at home.

As we live in an ageing society, the risk of injuries is at a higher scale compared to previously. In this day and time, 30% of those hospitalised are the elderly. Ageing causes the weakening of the musculoskeletal system and the inability to maintain an independent function.

Fractures

Fractures happen more commonly in the elderly for many reasons. Firstly, there is a reduction in bone mineral which leads to eventual fractures of the spine and wrist. This is significantly in post-menopause females. Next, the vision of the elderly is not that great compared to the young and healthy ones. With an impaired vision, it is inevitable that unexpected events will occur. This coupled with weak bone structures are the best combination for fractures.

Dislocations

The shoulder joint is the most easily dislocated mainly due to the extreme flexibility property. This is also the increased risk of dislocation due to the breaking of a fall using a shoulder. Severe pain is often experienced immediately and a depression will usually be formed in the lateral shoulder. Shoulder dislocations will require a period of immobilisation for at least a period of 6 weeks.

Osteoporosis

Osteoporosis is a bone disease characterised by low bone mass and decreased bone density. It occurs due to the inability for new bone formation to catch up with existing bone loss and an eventual weakening of the bone. This is especially common in the elderly due to the inefficiency of bone forming due to ageing as our bone mass peaks at 30 years of age and starts to go into decline after that.

Osteoarthritis

Osteoarthritis is the most prevalent type of degenerative disease and occurs more commonly in the elderly. Osteoarthritis affects the synovial joints as well as the spine, finger, ankle and knee joints. Osteoarthritis will have a negative impact on the daily activities of the patient and simple chores such as tying shoelaces or button a shirt may seem to be a tedious task to accomplish.

Orthopaedic injuries are the main culprit of injuries in elderly patients due to a combination of factors such as impaired vision which leads to falls and subsequent fractures and dislocations. Although degenerative diseases are mostly unavoidable, preventive steps can be taken when you are still young such as the intake of sufficient calcium before bone mass peaks to prevent complications when you are old. Stay happy and healthy folks!

Questions To Ask Before Orthopaedic Surgery

Orthopaedic surgeries are major surgeries and are extremely stressful. There will be a lot of doubts going through your head and can trigger an anxiety breakdown. However, this can be controlled by asking questions prior to your surgery. Being knowledgeable about what you are about to go through will allow you to appreciate the entire surgical process, prepare yourself for it and set in mind a proper recovery plan post surgery. So what are some questions that you should be asking your surgeon before surgery?

Why am I doing this surgery?

It is easy to Google online for information regarding the particular surgery you are about to undergo. However, there is no clear answer to why you are doing the surgery. You should be asking your surgeon why he recommended this particular surgery for you and are there any other alternative treatment methods that are available as well as a comparison between the possible alternatives. This will allow you to have a high confidence level prior to surgery.

What are the risks?

Risks are inevitable in any surgery and some carry a higher risk level than others. It would be good to clarify on this issue as well as question about some surgical procedures which have lesser risk level such as the use of a local anaesthesia as compared to a general anaesthesia as studies have shown that patients who received general anaesthesia have a higher risk of post surgery bleeding.

What are the available pain relief methods?

Pain and discomfort is also unavoidable post surgery and some people have a lower pain threshold than others. Therefore, it is crucial to understand about the available pain relief methods which will help you get through this tough period. You should also know what medications you are allergic to so that proper medication can be administered to you.

What are the success rates?

Bluntly speaking, you undergo surgery with the hope that it is a success. However, as you have already known, some surgeries carry a higher risk factor than others and therefore the success rates will fluctuate. Knowing what the success rates are will allow you to make better plans for your future.

No matter what orthopaedic surgery you are about to undergo, you should always ask questions prior to it to clarify your doubts and set your mind at ease. Here’s wishing you to a successful surgery and quick post-surgery recovery.

How Does Yoga Reduce Orthopaedic Injuries?

No one in this world is born perfect. There are imbalances in various parts of our body and this can cause injuries if mishandled. Many sports athletes are now turning to an ancient form of practice – Yoga. Yoga helps to increase the flexibility and physical as well as mental strength of oneself. It helps to prevent injuries associated with overuse and speed up recovery of existing injuries.

Yoga is normally conducted in a room that is slightly warm. This increase in temperature will allow muscles to expand and relax, allowing for an increase in stretching capabilities. Enhanced stretching will help to lower the risk of injuries. Yoga will help to build up physical strength and tone muscles, especially vulnerable ones such as the back muscles. It also increases flexibility, reducing injuries that are sustained due to the inability to flex. Since yoga causes perspiration, it will draw out toxins and impurities from the body, burn excess calories and help to build up endurance levels.

Orthopaedic injuries are all about the joints and musculoskeletal system. Having strong joints and muscles will help to significantly lower the risk of injuries. For example, athletes that are involved in high tempo activities such as basketball and soccer are at a high risk of ankle sprains. Due to the constant running and jumping motion, this causes a lot of high stresses to build up at the joints. Without sufficient rest, it can lead to overuse injuries and eventually soft tissue damages. Not only does yoga help to strengthen these joints, it also helps to reduce body weight to reduce the cyclic stresses acting on weak areas of the body.

You may be thinking basic warm up and cool down stretches also help to increase body heat and relax the muscles, increasing flexibility. What is so special about yoga? Well, the main difference is that yoga goes beyond stretching the “common” muscles. Normal stretches simply stretch the muscles in a one direction plane. However, this is rather useless for sports since sports is a 3 dimensional activity whereby the stresses come in the x, y and z plane. Yoga helps to stretch all the muscles in all the directions including the small ones to better prepare for what is to come during the games. Additionally, how yoga differs from ordinary stretching lies in its breathing during the practice. The emphasis of muscles isolation, works on specific muscles and in general stronger muscles would reduce the risk of sustaining orthopaedic injuries. In fact, stronger muscles also reduce the extent of an injury as well as recovery rate. Generally a stronger individual would be able to recover faster than an individual with weak muscles.

Yoga is an ancient activity that helps to warm up your muscles, increase the flexibility and build up your physical and mental strength through various poses and motion. With thousands of years of history, it is tried and tested by many.

Prodigy boy, 9, scores A* for two O-level maths papers

anthony aquathlon 2012Anthony Yip took two O-level mathematics papers last year as a private candidate and scored A* in both. He was then nine and a Primary 4 pupil at Henry Park Primary School.

He says he finished the two-hour papers much earlier than his older peers but did not want to draw attention to himself by handing in the paper first. He says: “I waited till the first person handed in the paper, then I handed in mine.”

His father, orthopaedic surgeon Kevin Yip, 51, says the boy had three months’ worth of twice-weekly tutoring before the examinations. The O-level examinations are normally done by those nine years older.

“We were just trying him out to see if he was a prodigy like his siblings,” says Dr Yip, who is married to Dr Joanna Lin, 49, an oncologist.

 

 

 

Source: The Straits Times

Spine Surgery: Orthopaedic Surgeon or Neurosurgeon?

In the event that you require spinal surgery to cure your injured back, the first and most important decision you have to make is to choose between an orthopaedic surgeon or a neurosurgeon. The choice of the right surgeon is extremely important and you have to consider factors such as the experience and success rate of the surgeon. So how different are these 2 doctors?

You will first need to understand that both are able to carry out spine surgery. In the past, neurosurgeons were the only ones that could qualify to perform spine surgery. With the evolution in medical techniques, orthopaedic surgeons are well equipped with the knowledge and skills to carry out spine surgeries for patients as well.

Neurosurgeons are medically trained doctors who have completed at least a 4 to 7 years worth of gruelling neurosurgery residency. Neurosurgeons specialise in disorders affecting the nervous system including the brain, spinal cord and nerves. There is however one distinct part that sets them apart from orthopaedic surgeons. Neurosurgeons are the only people who are able to perform surgery that is inside the dura mater of the spine. If the patient has a tumour in the spinal cord, cysts or spinal cord malfunction, only a neurosurgeon is able to perform the surgery for him.

Orthopaedic surgeons on the other hand are medically trained doctors who have completed a 5 years surgical residency focusing on musculoskeletal disorders such as the bones and joints. Most orthopaedic doctors focus on sports injuries and bone disorders. Some orthopaedic surgeons will choose to focus on spinal injuries and they will have to spend additional few years of their time to complete fellowship training on the spine. Other than the few specialised surgeries that only a neurosurgeon can carry out, orthopaedic doctors are able to carry out other spinal surgeries.

When choosing a surgeon to perform spinal surgery for you, the main question is not to decide on whether an orthopaedic surgeon or a neurosurgeon since both are equally adept to perform the surgery. Instead, you should be asking what is his specialisation. Some are specialised in cervical spine surgeries while some are inclined to lumbar disorders. The important questions you would want to ask is how many similar surgeries have they performed to date and what are the success rates. Spinal surgery being a major surgery, you would want a very experienced surgeon to perform it on you.